Background + Treatment
Carcinogenesis
Emerging Issues
100

Yusuf suffers from chronic inflammation … which type of CRC does he most likely have?

Collitis-associated

100

Fill in the blank. Mrs. Johnson is an active smoker. Compared to a non-smoker, she is ______X more likely to develop CRC.

2/Two

100

At just 26 years old, Yusuf’s CRC was most often diagnosed at which stages compared to older adults?

Stage III or IV

200

Mrs. Johnson has a history of CRC. Her cancer developed due to a mutation in BRAF caused by a change in the colon environment … which type of CRC does she most likely have?

Sporadic CRC

200

Yusuf has a diet low in vegetables and fibre. Which CRC mechanism does this factor drive?

CIN/Chromosomal Instability

200

Mrs. Johnson’s tumor biopsy is tested for immunotherapy eligibility. Which subtype responds best to treatment MSI-H/dMMR or MSS/pMMR? 

MSI-H/dMMR

300

Why does Yusuf’s low vegetable and fruit consumption increase his risk of CRC?

Causes gut dysbiosis

300

Mrs. Johnson’s colonoscopy shows a sessile serrated polyp in the proximal colon. Which molecular mutation is most commonly found in this lesion?

BRAF 

300

Doctors discover Yusuf’s tumor carries DNA damage from a bacterial toxin produced by certain E. coli. What is this toxin called?

Colibactin

400

Mrs. Johnson undergoes immunotherapy, in which T-cells are removed from her tumor, cultured in a lab, and then infused into her bloodstream once again. Which method of immunotherapy is this?

Tumor infiltrating lymphocytes (TILs)

400

Yusuf’s adenoma acquires a TP53 mutation. What does this mutation allow the tumor cells to do?

avoid apoptosis & proliferate while gaining mutations

400

In the KEYNOTE-177 trial, Mrs. Johnson received a PD-1 inhibitor that doubled progression-free survival over chemotherapy. What is this drug?

Pembrolizumab (Keytruda)

500

Yusuf undergoes targeted drug therapy where he’s given bevacizumab - a drug that kills cancer cells by limiting blood supply. What treatment method does this drug fall under?

Anti vascular endothelial growth factor antibodies

500

Mrs. Johnson’s tumor shows loss of MLH1 expression. Which laboratory test would confirm MSI status?

Imunohistochemistry for MMR proteins 

500

Yusuf’s generation (1990s) faces up to five times higher EO-CRC risk than Mrs. Johnson’s. Which early-life exposures help explain this?

Childhood antibiotics, formula feeding, C-sections, processed diet, reduced activity

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